A walk-and-eat intervention improves outcomes for patients with esophageal cancer undergoing neoadjuvant chemoradiotherapy
Journal
Oncologist
Journal Volume
20
Journal Issue
10
Pages
1216-1222
Date Issued
2015
Author(s)
Abstract
Background Preserving functional walking capacity and nutritional status is important for patients with esophageal cancer, but no effective intervention is available, particularly during active treatment. Methods. This pilot randomized controlled trial tested the effects of a walk-and-eat intervention for patients with esophageal cancer undergoing neoadjuvant chemoradiotherapy. Participants with locally advanced esophageal cancer stage IIB or higher (n = 59) were randomly assigned to receive the walk-and-eat intervention (n = 30; nurse-supervised walking three times per week and weekly nutritional advice) or usual care (n = 29; control group) during 4–5 weeks of chemoradiotherapy. Primary endpoints were changes in distance on the 6-minute walk test, hand-grip strength, lean muscle mass, and body weight between initiation and completion of intervention. Results. Participants (mean age: 59.6 years) were mostly male (92.9%) with squamous cell carcinoma (96.4%). During chemoradiotherapy, participants who received the walk-and-eat intervention had 100-m less decline than controls in walk distance (adjusted p = .012), 3-kg less decrease in hand-grip strength (adjusted p = .002), and 2.7-kg less reduction in body weight (adjusted p < .001), regardless of age. The intervention group also had significantly lower rates of need for intravenous nutritional support and wheelchair use. Conclusion. The nurse-led walk-and-eat intervention is feasible and effective to preserve functional walking capacity and nutritional status for patients with esophageal cancer undergoing neoadjuvant chemoradiotherapy. ? AlphaMed Press 2015.
Other Subjects
cisplatin; etoposide; fluorouracil; paclitaxel; adult; Article; cancer staging; chemoradiotherapy; controlled study; dietary intake; dynamometer; esophagojejunostomy; esophagus cancer; esophagus hemorrhage; esophagus rupture; female; fever; follow up; hand grip; healing impairment; human; major clinical study; male; neoadjuvant chemoradiotherapy; neutropenia; nutritional support; priority journal; prospective study; radiation dose; randomized controlled trial; squamous cell carcinoma; thrombocytopenia; tracheoesophageal fistula; treatment outcome; walking; weight reduction; aged; body weight; Carcinoma, Squamous Cell; chemoradiotherapy; Esophageal Neoplasms; hand strength; middle aged; neoadjuvant therapy; nutritional status; pathophysiology; randomization; Aged; Body Weight; Carcinoma, Squamous Cell; Chemoradiotherapy; Esophageal Neoplasms; Female; Hand Strength; Humans; Male; Middle Aged; Neoadjuvant Therapy; Nutritional Status; Random Allocation; Treatment Outcome; Walking
Publisher
AlphaMed Press
Type
journal article